Diabetic Neuropathic Pain
Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes. High blood sugar (glucose) can injure nerves throughout your body. Diabetic neuropathy most often damages nerves in your legs and feet.
Depending on the affected nerves, symptoms of diabetic neuropathy can range from pain and numbness in your legs and feet to problems with your digestive system, urinary tract, blood vessels and heart. Some people have mild symptoms. But for others, diabetic neuropathy can be quite painful and disabling.
Diabetic neuropathy is a common and serious complication of diabetes. But you can often prevent diabetic neuropathy or slow its progress with tight blood sugar control and a healthy lifestyle.
Symptoms of Diabetic Neuropathic Pain
Peripheral neuropathy
- Numbness or reduced ability to feel pain or temperature changes
- Tingling or burning sensation
- Sharp pains or cramps
- Increased sensitivity to touch — for some people, even the weight of a bedsheet can be painful
- Muscle weakness
- Loss of reflexes, especially in the ankle
- Loss of balance and coordination
- Serious foot problems, such as ulcers, infections, and bone and joint pain
Autonomic neuropathy
- A lack of awareness that blood sugar levels are low
- Bladder problems, including urinary tract infections or urinary retention
- Constipation, uncontrolled diarrhea or both
- Slow stomach emptying (gastroparesis), causing nausea, vomiting, bloating
- Difficulty swallowing
- Increased or decreased sweating
- Problems controlling body temperature
- Changes in the way your eyes adjust from light to dark
- Increased heart rate at rest
- Vaginal dryness
- Erectile dysfunction
- Decreased sexual response
Radiculoplexus neuropathy (diabetic amyotrophy)
- Severe pain in a hip and thigh or buttock that occurs in a day or more
- Eventual weak and shrinking thigh muscles
- Difficulty rising from a sitting position
- Abdominal swelling, if the abdomen is affected
- Weight loss
Mononeuropathy
Mononeuropathy, or focal neuropathy, is damage to a specific nerve in the face, middle of the body (torso) or leg. It’s most common in older adults. Mononeuropathy often strikes suddenly and can cause severe pain. However, it usually doesn’t cause any long-term problems.
Symptoms usually go away without treatment over a few weeks or months. Your specific signs and symptoms depend on which nerve is involved. You may have pain in the:
- Shin or foot
- Lower back or pelvis
- Front of thigh
- Chest or abdomen
- Difficulty focusing
- Double vision
- Aching behind one eye
- Paralysis on one side of your face (Bell's palsy)
Causes of Diabetic Neuropathic Pain
Damage to nerves and blood vessels
The exact cause likely differs for each type of neuropathy. Researchers think that over time, uncontrolled high blood sugar damages nerves and interferes with their ability to send signals, leading to diabetic neuropathy. High blood sugar also weakens the walls of the small blood vessels (capillaries) that supply the nerves with oxygen and nutrients. However, a combination of factors may lead to nerve damage, including:
- Inflammation in the nerves caused by an autoimmune response. The immune system mistakes nerves as foreign and attacks them.
- Genetic factors unrelated to diabetes may make some people more likely to develop nerve damage.
- Smoking and alcohol abuse damage both nerves and blood vessels and significantly increase the risk of infection.
Treatment of Diabetic Neuropathic Pain
- Slow progression of the disease
- Relieve pain
- Manage complications and restore function
